Cpap therapy adaptation system to mitigate pulmonary hyperinflation and method of operation thereof

Abstract

A positive airway pressure therapy device, which may include one or more of at least one controller; a flow generator configured to provide therapeutic air assist; a plurality of sensors including at least one electrocardiogram (ECG) sensor, and at least one photoplethysmogram (PPG) sensor, the at least one PPG sensor may be configured to determine hyperinflation and the implication on variability in stroke volume and ejection fraction and form corresponding stroke volume (SV) and ejection fraction (EF) information, and the at least one ECG sensor configured to sense heart rate (HR) and heart rate variability (HRV) and form corresponding HR and HRV sensor information; the at least one controller may be configured to: control a flow generator to provide the therapeutic air assist to the user in accordance with initial pressure values determined in accordance with default setting values; and may determine whether a venous return flow (VRF) is less than a venous threshold.

What is claimed is: 
     
         1 . A positive airway pressure therapy device, comprising:
 at least one controller;   a plurality of sensors including at least one electrocardiogram sensor, at least one photoplethysmogram, and at least one flow sensor, the at least one flow sensor configured to determine inspiratory and expiratory flow and form corresponding inspiratory and expiratory flow information, and the at least one ECG sensor configured to sense physiological parameters of a user and form corresponding ECG sensor information;   the at least one controller configured to:
 control a flow generator to provide therapeutic air assist to the user in accordance with an initial setting mode; 
 determine a rise time of expiration based upon the expiratory flow information; 
 compare the rise time of expiration to a threshold rise time of expiration value to determine whether the rise time of expiration is less than the threshold rise time of expiration value; 
 determine hyperinflation is critical when the at least one controller determines that the rise time of expiration is less than the threshold rise time of expiration value; and 
 control the flow generator to operate in accordance with a hyperinflation mode to reduce therapeutic air assist to the user when the at least one controller determines that the hyperinflation is critical. 
   
     
     
         2 . The PAP therapy device according to  claim 1 , wherein the at least one controller is further configured to control the flow generator to reduce at least one of Bi-flex, C-flex, and A-flex settings of the PAP therapy device by a threshold pressure value when in the hyperinflation mode. 
     
     
         3 . The PAP therapy device according to  claim 1 , wherein the at least one controller is further configured to control the flow generator to decrease duration of pressure support during inspiration cycle for N breath cycles by a threshold time value when in the hyperinflation mode, where N is an integer. 
     
     
         4 . The PAP therapy device according to  claim 1 , wherein the at least one controller is further configured to control the flow generator to decrease expiration pressure by a threshold pressure value when the PAP therapy device is in one of the hyperinflation mode and in a BiPAP therapy mode. 
     
     
         5 . The PAP therapy device according to  claim 1 , wherein the at least one controller is further configured to control the flow generator to reduce at least one of duration of pressure support during inspiration cycle and inspiration pressure by corresponding threshold amounts when in the hyperinflation mode. 
     
     
         6 . The PAP therapy device according to  claim 1 , wherein the plurality of sensors includes a chest sensor and an abdominal area sensor configured to measure a breathing pattern and extension of a chest of the user and form corresponding chest inflation sensor information. 
     
     
         7 . The PAP therapy device according to  claim 6 , wherein the at least one controller is further configured to compare the chest inflation sensor information to a threshold chest inflation value. 
     
     
         8 . The PAP therapy device according to  claim 7 , wherein when in the hyperinflation mode, the at least one controller is further configured to determine the hyperinflation is not critical when the CISI is determined to be less than the Tci. 
     
     
         9 . The PAP therapy device according to  claim 8 , wherein the at least one controller is further configured to control the flow generator to return to operation in accordance with the initial setting mode to restore therapeutic air assist to the user in accordance with the initial setting mode, when the at least one controller determines that the hyperinflation is not critical. 
     
     
         10 . The PAP therapy device according to  claim 9 , wherein the at least one controller is further configured to save in a memory current hyperinflation mode operating parameters of the flow generator prior to returning to operation in accordance with the initial setting mode from the hyperinflation mode. 
     
     
         11 . The PAP therapy device according to  claim 10 , wherein when the at least one controller determines that the hyperinflation is critical, the at least one controller is further configured to change operating parameters of the flow generator to the saved current hyperinflation mode operating parameters. 
     
     
         12 . The PAP therapy device according to  claim 1 , wherein the at least one controller is further configured to determine the hyperinflation is not critical when the at least one controller determines that the rise time of expiration is not less than the threshold rise time of expiration. 
     
     
         13 . The PAP therapy device according to  claim 8 , wherein the at least one controller is further configured to control the flow generator to return to operation in accordance with the initial setting mode to restore therapeutic air assist to the user in accordance with the initial setting mode, when the at least one controller determines that hyperinflation is not critical. 
     
     
         14 . The PAP therapy device according to  claim 1 , wherein the at least one controller is further configured to obtain PPG sensor information from the at least one PPG sensor and determine variability in stroke volume and ejection fraction and form corresponding stroke volume and ejection fraction information. 
     
     
         15 . A positive airway pressure therapy device, comprising:
 at least one controller;   a flow generator configured to provide therapeutic air assist;   a plurality of sensors including at least one electrocardiogram sensor, and at least one photoplethysmogram sensor, the at least one PPG sensor configured to determine variability in stroke volume and ejection fraction and form corresponding stroke volume and ejection fraction information, and the at least one ECG sensor configured to sense heart rate and heart rate variability and form corresponding HR and HRV sensor information;   the at least one controller configured to:
 control the flow generator to provide the therapeutic air assist to the user in accordance with initial pressure values determined in accordance with default setting values; 
 determine whether venous return flow is less than a venous threshold for venous return flow and whether stroke volume is less than a stroke threshold for stroke volume; and 
 decrease the initial pressure values by a default pressure value for N breath cycles, where N is an integer, when the at least one controller determines that the venous return flow is less than the threshold for venous return flow and the stroke volume is less than the threshold for stroke volume.